Provider Demographics
NPI:1073282794
Name:MINDFUL MATTERS LLC
Entity Type:Organization
Organization Name:MINDFUL MATTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:802-356-1773
Mailing Address - Street 1:1361 BACK RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ROYALTON
Mailing Address - State:VT
Mailing Address - Zip Code:05068-5017
Mailing Address - Country:US
Mailing Address - Phone:802-356-1773
Mailing Address - Fax:
Practice Address - Street 1:1361 BACK RIVER RD
Practice Address - Street 2:
Practice Address - City:SOUTH ROYALTON
Practice Address - State:VT
Practice Address - Zip Code:05068-5017
Practice Address - Country:US
Practice Address - Phone:802-587-2773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty